Healthcare Provider Details

I. General information

NPI: 1730946864
Provider Name (Legal Business Name): ARNUMENTARIUM MEDICAL PRACTICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 MARKET ST
WARREN PA
16365-1225
US

IV. Provider business mailing address

2025 PA AVE E
WARREN PA
16365-3229
US

V. Phone/Fax

Practice location:
  • Phone: 814-757-6505
  • Fax: 814-757-4310
Mailing address:
  • Phone: 814-757-6505
  • Fax: 814-757-4310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DIEN VIET LE
Title or Position: OWNER
Credential: MD
Phone: 814-757-6505